PARTCRX

Plan Summary

Insurance Type
Medicare Advantage Plan (Part C w/ RX)
Insurance Provider
MercyCare Health Plans
CMS Rating
Plan Type
HMO SNP
Annual Deductible
$360.00

What To Know About This Plan

  • This plan has health and drug coverage

Why We Like This Plan

  • has both Health and Drug Coverage

All cost-sharing assumes in-network healthcare providers.

Plan Details

Costs and Other Important Information

Plan Year:
2016
Optional Supplemental Benefits?
No
Choice of Doctors?
Plan Doctors for Most Services
Prescription Drugs Covered?
Yes
Out-Of-Pocket Spending Limit
$6,700 In-network
Other Health Plan Deductibles?
No
Health Plan Deductible
Coming soon
Monthly Drug Plan Premium
$0.00
Monthly Health Plan Premium
$0.00

Benefits

Service
Cost
Ambulance
0% or 20%
Doctor's office visits
Primary Physician
0% or 20% per visit
Specialist
0% or 20% per visit
Durable medical equipment (wheelchairs, oxygen, etc.)
0% or 20% per item
Emergency care
0% or 20% per visit (always covered)
Home health care
You pay nothing
Mental health care
Coming soon
Outpatient hospital
0% or 20% per visit
Renal dialysis
0% or 20% per visit
Inpatient hospital care
Coming soon
Skilled Nursing Facility (SNF)
Coming soon

Cost Sharing Information

Prescription Drug Copay/Coninsurance Details - Initial Coverage Limit

30 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred Generic15% coinsurance15% coinsuranceNot offered
Tier 2: Non-Preferred Generic
Tier 3: Preferred Brand Name
Tier 4: Non-Preferred Brand Name
Tier 5: Specialty Tier
90 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred Generic15% coinsurance15% coinsurance15% coinsurance
Tier 2: Non-Preferred Generic
Tier 3: Preferred Brand Name
Tier 4: Non-Preferred Brand Name
Tier 5: Specialty Tier

CMS Ratings

Staying healthy - screenings, tests and vaccines

Breast cancer screening
Colorectal cancer screening
Annual flu vaccine
Improving or maintaining physical health
Improving or maintaining mental health
Monitoring physical ability
Adult BMI assessment

Managing Chronic Conditions

Special needs plan care management
Care for older adults – medication review
Care for older adults – functional status assessment
Care for older adults – Pain screening
Osteoporosis management in women who had a fracture
Diabetes care – eye exam
Diabetes care – kidney disease monitoring
Diabetes care – blood sugar controlled
Controlling blood pressure
Rheumatoid arthritis management
Reducing the risk of falling
Plan all-cause readmissions

Member Experience with Health Plan

Getting needed care
Getting appointments and care quickly
Customer service
Overall rating of health care quality
Overall rating of plan
Care Coordination

Member Complaints, and Changes in Health Plan's Performance

Complaints about the health plan
Members choosing to leave the health plan
Beneficiary access and performance problems
Health plan quality improvement

Health Plan Customer Service

Plan makes timely decision about appeals
Reviewing appeals decisions
Call center – foreign language interpreter and TTY/TDD availability - Medical

Drug Plan Customer Service

Call center – foreign language interpreter and TTY/TDD availability - Drugs
Appeals auto-forward
Appeals upheld

Member Complaints, and Changes in Drug Plan's Performance

Complaints about the drug plan
Members choosing to leave the drug plan
Beneficiary access and performance problems
Drug plan quality improvement

Member Experience with Drug Plan

Rating of drug plan
Getting needed prescription drugs

Drug Pricing and Patient Safety

MPF Price Accuracy
High risk medication
Part D medication adherence for diabetes
Part D medication adherence for hypertension
Part D medication adherence for cholesterol
Medication Therapy Management program completion rate

Physician Finder

Physicians that accept Mercy Care Advantage (HMO SNP) for Arizona

/
SEPTER, JOHN
2816 S 4TH AVE
YUMA, AZ 85364
LWIN, TIN
2400 S AVE A
YUMA, AZ 85364
HERMENAU, SHAWN
2851 S AVENUE B
YUMA, AZ 85364
GALANG, TIMOTHY
1320 W 24TH ST
YUMA, AZ 85364
MCCULLARS, EVA
2501 S ARIZONA AVE
YUMA, AZ 85364
CHEUNG, PETER
1763 W 24TH ST
YUMA, AZ 85364
FREIMUTH, RICHARD
120 W 24TH ST
YUMA, AZ 85364
RUNYAN, DONALD
2400 S AVENUE A
YUMA, AZ 85364
KHAN, MOHAMMAD
1025 W 24TH ST
YUMA, AZ 85364
DICKSON, MATTHEW
2400 S AVENUE A
YUMA, AZ 85364
CARSON, JOHN
2400 S AVENUE A
YUMA, AZ 85364
SISON, CYNTHIA
2359 S 22ND DR STE 2
YUMA, AZ 85364
MAHALINGAM, JAYAREENA
2400 S AVENUE A
YUMA, AZ 85364
MICHAEL, SULTAN
2140 W 24TH ST
YUMA, AZ 85364
KRAVITZ, ALAN
1881 W. 24TH STREET
YUMA, AZ 85364
ROJAS, TIRSO
2400 S AVE A
YUMA, AZ 85364
KEMMOU, AHMED
1841 W 25TH ST STE C
YUMA, AZ 85364
MICHELI, ORLANDO
2400 S AVENUE A
YUMA, AZ 85364
SLOMINSKI, SUSAN
2741 S 8TH AVE
YUMA, AZ 85364
AUNG, MOE
2060 W 24TH ST
YUMA, AZ 85364
OSMAN, KHIDIR
789 W 27TH ST
YUMA, AZ 85364
SANGHVI, ASHESH
1030 W 24TH ST
YUMA, AZ 85364
ESKER, ALEC
1390 W. 16TH STREET
YUMA, AZ 85364
FARBER, ERIC
2149 W 24TH ST
YUMA, AZ 85364
HENDERSON, RODNEY
2851 S AVENUE B
YUMA, AZ 85364
Details
JOHN SEPTER, DDS
Phone Number
(928) 726-6023
Office Locations
2816 S 4TH AVE
YUMA, AZ 85364
2816 S 4TH AVE YUMA AZ, 85364

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